# RANCH HOPE OMEGA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063532273
- **Authorized official:** AUGUSTUS P DIBBLE (CFO)
- **Authorized official phone:** (856) 935-1555

## Contact information

- **Practice address:** 45 SAWMILL ROAD, ALLOWAY, NJ 08001-0325
- **Practice address phone:** (856) 935-1555
- **Practice address fax:** (856) 935-5189
- **Mailing address:** PO BOX 325, ALLOWAY, NJ 08001-0325
- **Mailing address phone:** (856) 935-1555
- **Mailing address fax:** (856) 935-5189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 37400000X | NJ | Yes |

## Other

- **Enumeration date:** 03/30/2007
- **Last updated:** 02/02/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0216135 | MEDICARE ID-TYPE UNSPECIFIED | NJ |